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急性胰腺炎在大麻使用者中的罕见不良反应:系统综述。

Acute pancreatitis as a rare adverse event among cannabis users: A systematic review.

机构信息

Department of Medicine, AMA School of Medicine, Makati, Philippines.

Department of Medicine, Jinan University, People Republic of China.

出版信息

Medicine (Baltimore). 2022 Jul 1;101(26):e29822. doi: 10.1097/MD.0000000000029822.

Abstract

BACKGROUND

Cannabis use has been steadily rising in the United States and can have multiple adverse effects, including cannabis-induced acute pancreatitis. This study aims to collate and highlight the significant demographics, clinical presentation, and outcomes in patients with cannabis-induced acute pancreatitis.

METHOD

A systematic literature search of electronic databases for peer-reviewed articles was conducted. After an initial search, we found 792 articles through different electronic databases. After manually removing duplicates and articles that did not meet the criteria, 25 articles were included in our review.

RESULTS

A total of 45 patients were studied, 35 (78%) cases were male and 10 (22%) cases were female, showing male predominance. The mean age of all participants was 29.2 ± 10.3 years. The most common presenting symptoms were abdominal pain 21 of 21 (100%), nausea 17 of 21 (81%), and vomiting 12 of 20 (60%). Ultrasound was normal in the majority of patients, with findings of mild pancreatitis. Computerized tomography scans revealed pancreatic edema and inflammation in 7 of 20 (35%) patients, and findings of necrotizing pancreatitis and complex fluid collection were visualized in 3 of 20 (15%) patients. Dilatation of intrahepatic or extrahepatic biliary ducts was not seen in any patients. The overall prognosis was good, with reported full recovery.

CONCLUSIONS

Cannabis should be included in the differential diagnosis for the etiology of acute pancreatitis, which would help in early intervention and treatment for the mitigation of the rapidly progressive disease.

摘要

背景

在美国,大麻的使用呈稳步上升趋势,可能会产生多种不良反应,包括大麻引起的急性胰腺炎。本研究旨在整理和强调患有大麻诱导性急性胰腺炎的患者的重要人口统计学、临床表现和结局。

方法

对同行评议文献的电子数据库进行了系统的文献检索。经过初步搜索,我们通过不同的电子数据库找到了 792 篇文章。手动去除重复项和不符合标准的文章后,我们的综述纳入了 25 篇文章。

结果

共有 45 名患者接受了研究,35 例(78%)为男性,10 例(22%)为女性,表现出男性为主。所有参与者的平均年龄为 29.2 ± 10.3 岁。所有患者最常见的表现症状为腹痛 21 例(100%)、恶心 17 例(81%)和呕吐 12 例(60%)。大多数患者的超声检查正常,表现为轻度胰腺炎。20 例患者中有 7 例(35%)的计算机断层扫描显示胰腺水肿和炎症,3 例(15%)显示坏死性胰腺炎和复杂液体积聚的影像学表现。没有患者出现肝内外胆管扩张。整体预后良好,报告完全恢复。

结论

应将大麻纳入急性胰腺炎病因的鉴别诊断中,这有助于早期干预和治疗,减轻疾病的快速进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2d0/9239618/334c7af86770/medi-101-e29822-g001.jpg

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